scholarly journals Repair of avulsion fracture of the anterior superior iliac spine by knotless suture bridge: Surgical technique and a review of 5 cases

2021 ◽  
pp. 19
Author(s):  
Keyword(s):  
Surgical Technique ◽  
Avulsion Fracture ◽  
Treatment Options ◽  
Visual Analogue Score ◽  
Anterior Superior Iliac Spine ◽  
Early Recovery ◽  
Suture Bridge ◽  
Pain Symptoms ◽  
Suture Bridge Technique

Background: Avulsion fracture of the anterior superior iliac spine (ASIS) is a rare form of apophyseal avulsion fracture of the pelvis, and there is a lack of evidence-based guidelines for the selection of treatment options. There are various surgical procedures, but there is the risk of secondary removal of internal fixator and growth disturbance caused by epiphyseal fixation. Methods: We treated 5 patients with avulsion fracture of the anterior superior iliac spine by knotless suture bridge technique who visited our hospital from 2015 to 2020.The surgical treatment results were retrospectively analyzed. Results: 5 patients with fractures were healed after the surgery, no associated complications, the mean postoperative follow-up was 29.2 months (6-60months), all patients were not reported pain symptoms (visual analogue score of 0), they don’t have the limitation of daily activities, and the hip joint function recovered well, and very pleased with the results (Harris score 100 points) at the final follow-up. Conclusion: Knotless suture bridge technique is simple and effective in the repair of the avulsion fracture of anterior superior iliac spine. For such patients, this surgical technique can provide stable and reliable fixation, allow early recovery, and provide a feasible scheme for clinical practice.

scholarly journals Extracorporeal shockwave therapy versus musculoskeletal mesotherapy for Achilles tendinopathy in athlete

2020 ◽  
Vol 47 (1) ◽  
Author(s):  
Reem EL-Mallah ◽  
Enas A. Elattar
Keyword(s):  
Treatment Options ◽  
Visual Analogue Score ◽  
Achilles Tendinopathy ◽  
Extracorporeal Shockwave Therapy ◽  
Extracorporeal Shockwave ◽  
Shockwave Therapy ◽  
Tendon Thickness ◽  
Vas Scores ◽  
Tendon Pathology

Abstract Background Achilles tendinopathy (AT) is considered the commonest tendon pathology, occurring mainly in athletes. Different conservative treatment options have been introduced but with short-term effects; however, extracorporeal shockwave therapy (ESWT) and mesotherapy (MT) injections were claimed to provide longer effects and could be used in cases failure of response to conservative treatments. The objective of our prospective 12-week study was to compare the effect of ESWT and MT on chronic Achilles tendinopathy in athletes by both clinical and ultrasonographical assessment. Results Forty patients with chronic AT diagnosed clinically and with high-resolution ultrasound (US) randomly allocated in two groups first received weekly ESWT session, and the other group underwent weekly MT sessions for 4 consecutive weeks. Both groups improved during the treatment and follow-up period. The mean visual analogue score (VAS) decreased in both the ESWT group and the MT group. Mean American Orthopedic Foot and Ankle Society (AOFAS) hindfoot score and VAS scores were not significantly different between ESWT and MT groups at the 4th and the 12th week of follow-up. However, US assessment significantly improved after 12 weeks in the ESWT group (as regards tendon thickness, calcifications, and Doppler signal), and for the mesotherapy group, there was the only improvement of tendon thickness. Conclusion ESWT showed improvement of pain and inflammation and calcifications of AT than MT injections, which was documented by US improved findings at week 12 follow up.

scholarly journals Suture Bridge Repair of Proximal Hamstring Avulsion: A Case Report

2020 ◽  
Vol 3 (1) ◽  
pp. 10-15
Author(s):  
Chad A. Edwards ◽  
Brian H. Goldman ◽  
Andrew Hadeed ◽  
Daniel Kalbac
Keyword(s):  
Technical Difficulty ◽  
Suture Bridge ◽  
Patient Morbidity ◽  
Surgical Fixation ◽  
Proximal Hamstring Avulsion ◽  
Proximal Hamstring ◽  
Anchor Fixation ◽  
Suture Bridge Technique ◽  
Severe Patient

Proximal hamstring avulsion injuries can represent a challenging problem and lead to severe patient morbidity if not treated appropriately. The most common method for acute surgical fixation involves the use of between two and five suture anchors in a variety of configurations. The five-anchor fixation has become the gold standard due to the increased biomechanical stability. However, the technique has also been criticized due to the need for greater exposure and technical difficulty. We report on an individual with a proximal hamstring avulsion injury who was managed with a modified approach, utilizing only three anchors in a suture bridge technique. The patient had good clinical outcomes at their 3-month follow-up visit, demonstrating this technique to be a viable option that is less technically demanding.

Arthroscopic Rotator Cuff Repair Using Modified Mason-Allen Medial Row Stitch

2012 ◽  
Vol 40 (11) ◽  
pp. 2440-2447 ◽  
Author(s):  
Yong Girl Rhee ◽  
Nam Su Cho ◽  
Chong Suck Parke
Keyword(s):  
Rotator Cuff ◽  
Clinical Results ◽  
Rotator Cuff Tears ◽  
Knot Tying ◽  
Suture Bridge ◽  
Group A ◽  
Group B ◽  
Arthroscopic Rotator Cuff ◽  
Suture Bridge Technique

Background: When using a method of suture bridge technique, there may be a possibility of strangulation of the rotator cuff tendon at the medial row. The style of knots chosen to secure the medial row might conceivably be a factor to reduce this possibility. Purpose: To compare the clinical results and repair integrity of arthroscopic rotator cuff repair between a knotless and a conventional knot-tying suture bridge technique for patients with full-thickness rotator cuff tears and to evaluate retear patterns in the cases with structural failure after arthroscopic repair by magnetic resonance imaging (MRI). Study Design: Cohort study; Level of evidence, 2. Methods: After arthroscopic repair for medium-sized rotator cuff tears, 110 patients available for postoperative MRI evaluation at least 6 months were enrolled in this study. According to the repair technique, 51 shoulders were enrolled in a knotless suture bridge technique group (group A) and 59 shoulders in a conventional knot-tying suture bridge technique group (group B). The mean age at the time of the operation was 61.0 years (range, 44-68 years) in group A and 57.6 years (range, 45-70 years) in group B. The mean follow-up period was 21.2 months (range, 12-34 months) and 22.1 months (range, 13-32 months), respectively. Results: The Constant score of group A increased from the preoperative mean of 65.2 points to 79.1 points at the last follow-up ( P < .001). The corresponding figures for group B improved from 66.6 points to 76.3 points ( P < .001). The preoperative Shoulder Rating Scale of the University of California at Los Angeles (UCLA) score was 21.1 points in group A and 18.3 points in group B. The UCLA score at the last follow-up was 31.0 points in group A and 27.9 points in group B ( P < .001, P < .001). Retear rate was significantly lower in group A (5.9%) than group B (18.6%) ( P < .001). In group B, retear occurred at the musculotendinous junction in 72.7%, but group A had no medial cuff failure. Conclusion: In arthroscopic suture bridge repair of full-thickness rotator cuff tears, clinical results of both a knotless and a conventional knot-tying group showed improvement without significant difference between the 2 groups. However, the knotless group had a significantly lower retear rate compared with the conventional knot-tying group. A knotless suture bridge technique could be a new supplementary repair technique to conventional technique.

Arthroscopic Repair of the Isolated Subscapularis Full-Thickness Tear: Single- Versus Double-Row Suture-Bridge Technique

2019 ◽  
Vol 47 (6) ◽  
pp. 1427-1433 ◽  
Author(s):  
Ji-Sang Yoon ◽  
Sung-Jae Kim ◽  
Yun-Rak Choi ◽  
Sang-Ho Kim ◽  
Yong-Min Chun
Keyword(s):  
Clinical Outcomes ◽  
Structural Integrity ◽  
Arthroscopic Repair ◽  
Full Thickness ◽  
Double Row ◽  
Single Row ◽  
Suture Bridge ◽  
Active Range Of Motion ◽  
Suture Bridge Technique

Background: No clinical comparative study has addressed isolated subscapularis tears after arthroscopic repair with either single-row or double-row suture-bridge technique. Purpose/Hypothesis: The purpose of this study is to compare clinical outcomes and structural integrity after arthroscopic repair of an isolated subscapularis full-thickness tear with either the single-row technique or the double-row suture-bridge technique. The authors hypothesized that there would be no significant differences in clinical outcomes and structural integrity between approaches. Study Design: Cohort study; Level of evidence, 3. Methods: This study included 56 patients who underwent arthroscopic repair of an isolated subscapularis full-thickness tear with grade II or less fatty infiltration in the subscapularis muscle with either a single-row technique (n = 31) or a double-row suture-bridge technique (n = 25). Functional outcomes were assessed with the visual analog scale (VAS) for pain, Subjective Shoulder Value (SSV), American Shoulder and Elbow Surgeons (ASES) score, the University of California, Los Angeles (UCLA) shoulder score, and active range of motion. Magnetic resonance arthrography (MRA) or computed tomographic arthrography (CTA) was performed 6 months after surgery to assess the structural integrity of the repaired tendon. Results: At the 2-year follow-up, all scoring parameters applied (VAS, SSV, ASES, and UCLA), subscapularis strength, and active range of motion improved significantly in both groups as compared with preoperative values ( P < .001). However, there were no significant differences between groups in any of these clinical outcome measurements (VAS, 1.2 vs 1.1; SSV, 91.3 vs 91.8; ASES, 91.0 vs 91.4; UCLA, 31.9 vs 32.1). On follow-up MRA or CTA, the overall retear rate did not differ significantly between the single-row group (13%, 4 of 31) and the double-row group (12%, 3 of 25). Conclusion: Arthroscopic single-row repair and double-row suture-bridge repair of isolated full-thickness subscapularis tears both yielded satisfactory clinical outcomes and structural integrity with no significant differences among patients with good muscle quality.

scholarly journals Suture Slippage After Arthroscopic Cuff Repair: Medial Displacement of Suture Knots on Follow-up Ultrasonography

2021 ◽  
Vol 9 (8) ◽  
pp. 232596712110218
Author(s):  
Hyungsuk Kim ◽  
Sung Bin Han ◽  
Hyun Seok Song
Keyword(s):  
Rotator Cuff ◽  
Rotator Cuff Repair ◽  
Case Series ◽  
Final Visit ◽  
Suture Bridge ◽  
Pull Out ◽  
Cuff Repair ◽  
Slippage Distance ◽  
Suture Bridge Technique

Background: Compared with the single-row technique, the double-row rotator cuff repair technique is known to have a higher load to failure and a lower frequency of gap formation, leading to a lower retear rate. There are some patients with poor clinical outcomes or poor muscle strength without radiologic retear. Purpose/Hypothesis: To assess the postoperative position of suture knots via serial ultrasonography in patients who had undergone arthroscopic rotator cuff repair with the suture-bridge technique. Our hypothesis was that the suture would pull out of the lateral anchor (suture slippage), changing the positions of the medial suture knots during healing. Study Design: Case series; Level of evidence, 4. Methods: This study included 53 patients (55 shoulders) who underwent arthroscopic suture-bridge repair and were evaluated for a minimum of 24 months. On serial ultrasonography, a straight line was drawn between the top of the greater tuberosity and the medial cortex of the anchor hole. The distances between the knots of the medial rows and the perpendicular line through the center of the anchor hole were measured in longitudinal plane images of the supraspinatus. Follow-up ultrasonography was performed at 2, 3, and 6 months postoperatively as well as at the final visit. The visual analog scale, the American Shoulder and Elbow Surgeons score, the Constant score, and the University of California, Los Angeles shoulder score were recorded preoperatively and on the final follow-up. Results: Of the 55 shoulders, 6 developed retears at repaired sites. The mean follow-up duration was 37.5 months (range, 24-65 months). Slippage distance increased significantly over time ( P < .001). The slippage at the final visit did not differ between patients with retear and no retear (13.4 mm for retear group; 10.6 mm for no retear group [ P = .096]). Conclusion: Suture knots of the medial row migrated medially via a suture pullout from the lateral row anchor of suture-bridge technique. Suture slippage distance did not differ significantly between retear and no retear groups.

Does the Dog-Ear or Bird-Beak Deformity Remodel After Rotator Cuff Repair?

2020 ◽  
Vol 48 (7) ◽  
pp. 1575-1582
Author(s):  
Yong Bok Park ◽  
Jung Ho Park ◽  
Seung Won Lee ◽  
Tae Wan Jung ◽  
Kyoung Hwan Koh ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Symptom Duration ◽  
Mri Scan ◽  
Level Of Evidence ◽  
Suture Bridge ◽  
Bird Beak ◽  
Magnetic Resonance Imaging Mri ◽  
Beak Deformity ◽  
Suture Bridge Technique

Background: Dog-ear and bird-beak deformities are common after transosseous-equivalent repair (suture bridge technique). The natural course of deformities after rotator cuff (RC) repair using the suture bridge technique is unclear. The remodeling potential of these deformities has not been investigated. Purpose: To evaluate remodeling and retear rates associated with deformities after RC repair. Study Design: Cohort study; Level of evidence, 3. Methods: Between November 2011 and February 2012, we studied 99 consecutive shoulders. All patients underwent arthroscopic RC repair via the suture bridge technique with or without additional sutures. Two groups were formed: no deformity (n= 46) and deformity (n = 53). Deformity was defined as marginal detachment and protrusion of the RC after repair, involving inappropriate compression of the suture limbs from the anchors. Tendon height was measured from the highest point of the most protruding portion of the cuff to the cortex on semi-coronal magnetic resonance imaging (MRI) scan. Change in tendon height was evaluated on MRI scan at 1 week and 6 months postoperatively. Clinical assessment at every patient visit included the American Shoulder and Elbow Surgeons (ASES) score, Constant shoulder score, and visual analog scale for pain (pVAS) score. Results: No significant differences were found in age, sex, symptom duration, tear size, and preoperative ASES, Constant, and pVAS scores ( P > .05) between the 2 groups. The initial tendon height was 7.4 ± 1.5 mm in the no-deformity group and 9.3 ± 2.0 mm in the deformity group. Follow-up height was 6.3 ± 2.1 mm in the no-deformity group and 6.4 ± 1.6 mm in the deformity group. Mean postoperative tendon heights were 90.1% ± 23.8% of the initial height in the no-deformity group and 73.2% ± 15.1% in the deformity group. Clinical scores (ASES, Constant, and pVAS) were not significantly different between the groups at 6 months. There were 4 shoulders in each group that experienced retearing (types 4 and 5 according to the Sugaya classification) at 6 months postoperatively. There was no difference in retear rate ( P > .999). Conclusion: Most deformities after RC repair were remodeled with no effect on retears. Clinical outcomes were not affected by deformities.

scholarly journals Avulsion fracture of the ischial tuberosity treated with the suture bridge technique: a case report

2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Tomonori Tetsunaga ◽  
Hirosuke Endo ◽  
Tomoko Tetsunaga ◽  
Kazuki Yamada ◽  
Takayuki Furumatsu ◽  
...  
Keyword(s):  
Case Report ◽  
Avulsion Fracture ◽  
Ischial Tuberosity ◽  
Suture Bridge ◽  
Suture Bridge Technique

scholarly journals Preliminary clinical outcomes of the double-row anchor suture-bridge technique for the fixation of tibial intercondylar eminence fractures in adults: a 12-months minimal follow-up

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Yupeng Chu ◽  
Ting Hu ◽  
Mangmang Chen ◽  
Chendi Jiang ◽  
Zhuqi Wu ◽  
...  
Keyword(s):  
Knee Joint ◽  
Clinical Outcomes ◽  
Double Row ◽  
Suture Bridge ◽  
Post Surgery ◽  
Intercondylar Eminence ◽  
The Mean ◽  
Suture Bridge Technique ◽  
Anchor Suture

Abstract Background Tibial intercondylar eminence avulsion fractures occur primarily in adolescents and young adults. However, the incidence of such fractures is increasing in adults, concurrent with an increase in sports injuries and traffic accidents. This study describes the fixation-based double-row anchor suture-bridge technique, a novel technique for treating tibial intercondylar eminence fractures in adults; and evaluates its preliminary clinical outcomes. Methods A retrospective evaluation of adult patients with tibial intercondylar eminence fractures treated at our institution from June 2016 to June 2018 was conducted. Seven such patients, treated with the anchor suture-bridge technique, were included. All patients were assessed for knee joint range of motion (ROM), Lysholm knee score, International Knee Documentation Committee (IKDC) Subjective Knee Evaluation Form score, Tegner activity score pre-surgery, and the healing of the fracture at 3, 6 and 12 months minimal post-surgery follow-up. Results Patients were followed for a mean of 12.43 months (range 9-15 months). By the final follow-up, all fractures had fully healed. The mean Lysholm score improved from 27.86 (range, 2 to 54) pre-surgery to 88.14 (range, 81 to 100) 3 months post-surgery (p < 0.05). Similarly, the mean IKDC score improved from 48.86 (range, 43 to 55) to 84.29 (range, 75 to 90) (P < 0.05); and the mean Tegner activity score improved from 1.71 (range, 0 to 4) to 3.29 (range, 2 to 4) (p < 0.05). Furthermore, knee joint ROM, Lysholm scores, IKDC scores, and Tegner activity scores displayed excellent outcomes at the 6 and 12 months minimal follow-up. Conclusion The arthroscopic anchor suture-bridge technique is a valid and secure method for achieving effective fixation of tibial intercondylar eminence fractures in adults.

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